[Congressional Record Volume 153, Number 156 (Tuesday, October 16, 2007)]
[House]
[Pages H11631-H11636]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  2130
                                 SCHIP

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 18, 2007, the gentleman from Texas (Mr. Burgess) is recognized 
for 60 minutes.
  Mr. BURGESS. Mr. Speaker, I'm not certain my voice is going to hold 
out for a full hour, but I will do my best.
  I come to the floor tonight to talk, as I do every week, about health 
care, the state of health care in America. We have an unusual week 
ahead of us here in the House of Representatives. Many people know that 
we have been debating the reauthorization of the State Children's 
Health Insurance Program for several months now.
  The bill that was passed on the floor of the House at the end of 
September was vetoed by the President and that bill, I'm assuming, will 
be coming back to the floor of the House this week to test the 
possibility of an override on the President's veto.
  Mr. Speaker, I support the reauthorization of the State Children's 
Health Insurance Program, as does, I suspect, almost everyone in this 
body. But, Mr. Speaker, the bill that we received the end of September 
was not a good bill to accomplish the purposes that we're looking to 
accomplish.
  Mr. Speaker, we need to focus on the poor children in this country 
and only expand the program after we're doing a good job taking care of 
the poor children and the near poor in this country. And I don't think 
we have yet met that test, and that's why I supported the

[[Page H11632]]

President when he vetoed the legislation; and I hoped that that would 
be an impetus for both sides to come back together in this House and 
work on that bill and get a product for the American people, a viable 
product to reauthorize the State Children's Health Insurance Program 
for the American people. Unfortunately, that has not, that expectation 
has not been met.
  Now, Mr. Speaker, the State Children's Health Insurance Program was 
introduced 10 years ago. You know, when we all stood up in this Chamber 
last January and raised our right hands and swore our oath to defend 
the Constitution, every man and woman among us in this body knew that 
September 30th of this year the State Children's Health Insurance 
Program was going to expire, was going to go away. It had a shelf life, 
and September 30th of 2007 was that date.
  I was very disappointed that we had only the most general hearings 
about insurance coverage in our Committee on Energy and Commerce. We 
never had a legislative hearing on the bill that we voted on at the end 
of July, the first part of August. We never had a subcommittee markup 
during the summer on the bill that we voted on the beginning of August. 
We had a bill that was delivered to us about 24 hours before it was 
rammed through the full committee on our Energy and Commerce Committee 
and then brought to the floor of this House.
  I had four amendments that I took to the Rules Committee. None were 
made in order. The bill was passed primarily on a party line vote, and 
it's called bipartisan. I guess that's what passes for bipartisanship 
in this town right now.
  But, Mr. Speaker, let me reemphasize, I support the reauthorization 
of the State Children's Health Insurance Program. In 1997, I wasn't 
here in this House. But a Republican House of Representatives, 
recognizing there was a gap between children whose parents made too 
much money to qualify for Medicaid and yet not enough money to be able 
to afford their own insurance coverage, there was a gap in the coverage 
for health insurance for children, and the Congress, in 1997, wisely, I 
think, stepped up and provided the leadership and provided the 
legislation that gave us a program that I think, arguably, has 
functioned very well for the past 10 years.
  But part of the wisdom, part of the reason of having a program be 
reauthorized after a set period of time is, let's step back and look at 
the program. Is it doing a good job? Is it functioning as intended? Are 
there things we could do better? Are there improvements that can be 
made? Are there areas where it could be streamlined? I think the answer 
to every one of those questions in regard to the State Children's 
Health Insurance Program was yes. And it's a tragedy, it's unfortunate 
that we never got a chance to even talk about any of those 
improvements. Instead, we got a very draconian process and a bill 
pushed through the House that was absolutely unacceptable to the 
President and, as a consequence, he vetoed it. And as a consequence, 
after 2 weeks of some of the most severe political hammering that has 
ever been seen in this country, we're now going to have a vote this 
Thursday on whether or not to override the President's veto.
  Mr. Speaker, in 1997 the committee on which I currently serve, the 
Committee on Energy and Commerce, crafted this original legislation. It 
was done with the best of intentions. There were children whose parents 
earned too much money for Medicaid. They earned over 150 percent of 
poverty. That's about a level of $35,000 for a family of four. But they 
didn't make enough money to pay for their own health insurance. Two 
hundred percent of poverty is a level of about $41,000 a year for a 
family of four. So the children who fell into that gap couldn't be 
covered under Medicaid, and their parents didn't quite make enough 
money to cover them on their employer-derived insurance.
  Now, about 50 percent of the children in that category did have 
employer-derived insurance, but the other 50 percent were the ones who 
needed help, and that's where the help was targeted.
  The program, as it was initially authorized, was a $40 billion 
program over 10 years' time. Every State had 3 years to spend its State 
allotment.
  Now, that's important in my home State of Texas because our 
legislature meets every 2 years. Anything less than a 3-year time 
period in which to spend the allotted money means that any changes that 
are made in the program won't have time to go into effect, and Texas 
would be at risk of losing some of those dollars under the bill passed 
by the House and vetoed by the President.
  Now, I said it before and I'll say it again. I think almost every 
person in this body wants to have this program reauthorized and wants 
to make certain that children have health care coverage. Let's ignore 
the question of cost for a moment. But I don't think we can ignore some 
of the other issues that surround this concept.
  What if we expand the program in a way that erodes, it takes away the 
component of commercial insurance that's available to families with 
children. Is that ultimately a good thing or a bad thing? Will the 
future look better or worse if we erode that private coverage?
  Now, raising taxes to pay for the program, if we have to do it, but 
Mr. Speaker, the funding mechanisms that are before us on this 
authorization actually disappear in 5 years. Under the current PAYGO 
rules of the House, the program has to be fully funded, so it's all 
front loaded. And guess what happens? Four or 5 years into the program, 
it falls off a cliff, and someone's going to have to deal with that 
cliff, someone who perhaps is currently serving in this body or someone 
who will be serving in this body, they will have to face those funding 
shortfalls in years to come.
  We all know that there are difficulties that face the Congress in the 
years ahead as far as paying for entitlement programs, so any time we 
expand an entitlement program, we have to be very careful, very careful 
that we have thought through the issue of funding support for the 
future, or else that very famous line of passing the cost on to our 
children and grandchildren, in fact, becomes a self-fulfilling 
prophecy.

  Mr. Speaker, some of the problems I see with the bill that was passed 
by this House at the end of September: The 2-year time interval to 
spend money by the States is, for a State with a 2-year legislative 
process, that's going to be mighty difficult.
  This program will be spending more money than the previous 
authorization of SCHIP. The current funding is to be $60 billion over 5 
years. Remember, the original SCHIP bill back in 1997 was $40 billion 
over 10 years. This bill will spend $60 billion over 5 years.
  There is no hard limit. Although you will hear people talk about the 
upper limit being 300 percent of poverty, because of income set-asides 
and disregards that are available to the States, there are no hard 
upper limits.
  But, Mr. Speaker, is that what the American people want? When we hear 
that this issue polls very well for Democrats and very poorly for 
Republicans, well, let's look into that just a little bit. A poll out 
just this week from USA Today shows a majority, over 50 percent of the 
people in this country, agree that poor children should be covered 
first. It's a fairly simple concept. And guess what? The American 
people get it. That's what they want to see us do, cover poor children 
first.
  Now, if we follow a process that allows those State disregards, those 
income disregards and set-asides and have a system of open-ended 
Federal funding for the States that go over budget, imagine what is 
going to happen when people in this body are faced with reauthorizing 
this program in 5 years' time.
  Now, one of the real pernicious aspects of this is that it shifts 
children who are participating in private insurance to a government 
program.
  Mr. Speaker, let's take a look at this next graph. We see, if we look 
at children whose families earn in the 100 to 200 percent of the 
Federal poverty limit, about half of those children have private health 
insurance. So it's this group of children that the SCHIP program 
initially set out to cover.
  Now, if we expand the eligibility limits between 200 and 300 percent 
of the Federal poverty limits, three out of four kids are already 
covered by private health insurance. If we go up to 300 percent of the 
Federal poverty limit, nine out of 10 are already covered. And if we go 
up to 400 percent of poverty, 95 percent of those children already have 
insurance. And yet some

[[Page H11633]]

States, two eastern States, have exceptions in the Democratic-passed 
bill which would allow children to be covered whose families earn up to 
400 percent of poverty.
  Well, Mr. Speaker, I submit that the universe of children in that 
group is pretty small that doesn't have health insurance. And to be 
sure, we should find them and help them. But do we want to move 
children who are already covered by viable commercial insurance, do we 
want to move them to a government program?
  What are we trying to do here? Grow the government or build stronger 
families? I'll vote for the families every time.
  Now, carve-outs for States, primarily States in the northeast, 
essentially requires other States to subsidize their programs. How's 
that going to happen?
  Well, a State like Texas that right now has 3 years to spend its 
State allotment is going to be cut back to 2 years. Our legislature met 
this last year in 2007. It won't meet again till 2009. So if their 
State allotment requires a higher level of spending or money is left on 
the table, guess what? The money's left on the table. But it's not 
really left on the table for very long. Where's it going to go? It's 
going to go to one of those States that is now allowed to cover 
children up to 400 percent of the Federal poverty limit. Well, I don't 
think anyone in Texas, if they really understood what was happening 
here, would be in favor at all of the bill that passed this House the 
end of September, and they would be very grateful that the President 
provided a backstop with a Presidential veto and said, Get back to the 
House and get back to work on that.
  Mr. Speaker, one of the real problems with the SCHIP bill, and one of 
the, when we talk about things that we could do to improve the SCHIP 
bill, one of the ways we've gotten away from those original intentions 
when this bill was passed back in 1997 is that we have allowed adults 
to be covered under the SCHIP program. In fact, there are four States 
right now that cover more adults than they do children. In fact, one 
State, 87 percent of the participants in the SCHIP program are not 
children. Well, that seems to fly in the face of what was a good and 
sound public policy at its inception.
  Now, to be sure, those waivers have been granted by the previous 
administration and by this administration. Well, they've got to stop. 
And certainly, the language in the current SCHIP bill that was voted on 
the floor of the House made moves in that direction, but nowhere near 
fast enough.
  Every dollar we spend on an adult in this program is money that we 
can't spend on a child. And you know what? It only costs about 60 
percent of the dollars to insure a child versus an adult. Children are 
relatively cheap to insure because they're healthy. If we take those 
dollars and displace them to the coverage of adults, we push 
proportionately more children off of the program. And I don't think 
that's what anyone had in mind. So ending the coverage of adults under 
the SCHIP program is certainly something we've got to pay strict 
attention to, and simply phasing it out in 5 years' time, in my mind, 
is probably not moving aggressively enough in that area.

                              {time}  2145

  Putting the children back in SCHIP ought to be one of our first 
principles, one of our first priorities in the reauthorization of this 
bill.
  Now, another pernicious aspect of the House-passed bill in September, 
and it's not a big deal, probably didn't get any headlines anywhere in 
this country, but eliminating some of the demonstration projects that 
were carefully crafted to try to look at other options for people who 
fall between the Medicaid and not quite being wealthy enough to provide 
their own health insurance, to allow States to have the flexibility to 
set up a health opportunity account, to allow a family to perhaps build 
and develop a medical IRA so that they can transition from a State-
based insurance program to a private-based insurance program in the 
future.
  Now, I saw a lot of patients in my medical practice who were covered 
under Medicaid. I had an obstetrics practice; and because of Texas 
State law, obstetrics is one of the things that is almost automatically 
covered under Medicaid. We saw a fair amount of Medicaid patients. But, 
Mr. Speaker, over time those families wanted to gravitate to a private 
insurance coverage because it was better coverage and they had more 
choice of whom they could see. They weren't so restricted in their 
choice of providers. Allowing them to begin to build the equity that 
will allow them to do that, well, I think that's a fundamental desire 
of a lot of young families who start out on one of the State or Federal 
assistance programs.
  Now, one of the really difficult issues for me back home with this 
bill, even though it is advertised differently, is that this bill will 
make it easier for people who are in our country without the benefit of 
citizenship or a Social Security number, it will make it easier for 
them to qualify in the State Children's Health Insurance Program. The 
citizenship verification requirement that is currently in the SCHIP 
authorization is eroded under the bill passed by the House. Now, they 
tell you that, no, we protect, it's only American citizens; but the 
reality is the CBO, Congressional Budget Office, that studies these 
things will tell you that the erosion of the verification process will, 
in fact, allow many more people in to have coverage that are in the 
country without the benefit of going through the legal process to be in 
this country.
  And the number is significant. The Congressional Budget Office 
estimates that over 10 years' time, that will account for about $3.5 
billion of new spending to cover people who are in the country without 
benefit of Social Security numbers.
  Shouldn't we be focusing on those children between 150 percent of 
poverty and 200 percent of poverty that we are not finding now: 
Shouldn't we be focusing on those instead before we begin to focus on 
people who are in the country without the benefit of citizenship? I 
think so. I know the constituents in my district back in Texas think 
so.
  We need to do a good job for the people who are here legally or are 
natural citizens of this country before we start reaching out to cover 
other populations. We can't cover those other populations at the 
expense of the people that we are required to take care of.
  Well, Mr. Speaker, I have a lot of concerns about the bill that 
passed the floor of this House, and I am grateful now that we are going 
to get another opportunity to visit that with a vote. The cost is high, 
but I don't think we should be focusing on cost. I think fundamental 
issues like freedom and I think fundamental issues of erosion of 
private coverage of insurance are more important than this argument.
  Now, wouldn't it be great if we gave families the help they needed to 
keep their kids on their employer-derived insurance? A family of four 
earning a little over $40,000 a year, if the mom and dad or the primary 
wage earner is covered under employer-derived insurance but they look 
at the cost of pulling the kids onto the policy, and it is just too 
much for us, we can't swing that, what if we took the approach that we 
are going to buy down the cost of that coverage for their children for 
them so that their children would have the coverage? Wouldn't that be 
better than just placing the children onto a State-run program? 
Wouldn't it be better if everyone in the family was covered under the 
same provider book? When it came time to go to the doctor or necessary 
to go to the doctor, you have just got to look in one book. You don't 
have to have a book for Mom and Dad, who are covered under the 
employer's policy, and a book for the kids, who are covered under the 
government policy. One policy that covers an entire family makes a lot 
of sense.
  Now, the current SCHIP bill, the one from 1997, does allow for the 
concept of premium support, but it is restricted in the total number of 
dollars that can be spent in that regard; and, quite frankly, there are 
so many obstructions and so many regulations that people get wrapped 
around the axle and they just never get through the process of getting 
that done. It's just easier to go down to fill out some paperwork and 
get on the full SCHIP program. Let's not worry with premium support. We 
can streamline that. We can make it easier.
  Now, to be fair, there were some attempts in the bill passed on the 
floor of the House last September, some attempts to streamline that 
process, but

[[Page H11634]]

we could go a lot farther. We actually ought to encourage that because, 
again, it builds healthy families and that is what we ought to be 
about, building healthy families, not building a bigger government or 
building a government with a bigger appetite. Let's build healthy 
families and give them the power to make the decisions.
  The other issue that we hear talked about a lot is, well, we are 
going to be covering many more kids with this program. But if we 
actually break the numbers down, the numbers are all over the map. You 
will hear quotes or read quotes from people who will talk about numbers 
that are literally all over the place. If you watched the Sunday shows, 
I don't think the same two numbers came out of the same person's mouth 
more than once. But if we break it down by the Congressional Budget 
Office and look at the population that will be covered that has 
previously not been covered, the number most consistently quoted is an 
additional 1.2 million children enrolled in the SCHIP program. But that 
includes about half of them who already have private health insurance 
coverage.
  So the actual number diminishes by about half, that 600,000 children 
will be the increase, the uptick in the number of children who are 
covered under the bill that we passed on the floor of the House at the 
end of September. It costs a lot of money to do that. And it's not that 
I mind spending the money on something as worthwhile as children; but, 
really, shouldn't we be ensuring that we are getting value for the 
dollar, and is that really the best way to go about doing it, putting 
half of them on private health insurance in order to cover the other 
600,000 children? I don't know that that is the wisest and best use of 
our time. I don't know that that is the wisest and best use of our 
dollars.
  We should strive to deliver value for the taxpayer in everything we 
do, whether it be national defense, whether it be transportation 
funding, whether it be legislation supporting research and development, 
or whether it be legislation supporting the State Children's Health 
Insurance Program. But, Mr. Speaker, I really think it would be better 
if we gave more families more power and gave them the option of buying 
down the cost of that private health insurance so that we could keep 
them in a program where both parents and the children are covered under 
the same policy. If we could make the improvements in the premium 
support provisions of the bill, we might actually give a family the 
ability to cover their kids under their employee health plan and keep 
them all together under one umbrella coverage.
  But this bill chooses to take those kids, about 600,000 who already 
have insurance, and push them into the SCHIP program.
  Mr. Speaker, instead of federalizing health care, instead of 
expanding the power and reach of the Federal Government, why don't we 
give families a lift and let the families make the best decisions? I 
think they will make the best decisions regarding their health and 
their families' health. But more and more families will be dropping 
private health insurance if this bill as passed by the House is allowed 
to stand.
  Mr. Speaker, again, we hear a lot of stuff about how this veto fight 
polls very well for Democrats and this is an election issue that has 
been handed to them and they wouldn't think of compromising because, 
after all, by golly, they are on the right side of this fight.
  But look at this, Mr. Speaker: Are Americans concerned that families 
would drop private coverage if they had the option to have a Federal 
program available to them? You bet they are. Fifty-five percent are 
concerned or very concerned about just this eventuality.
  Mr. Speaker, it's a shame when politics trumps sound public policy; 
but, unfortunately, we seem to be very much involved in a time where 
that's the coin of the realm and that's one of the things we are going 
to have to expect and work through.
  When you look at the State Children's Health Insurance Program passed 
in 1997, what was the situation? You had a Republican majority in 
Congress and you had a Democratic President, and they were able to work 
that out between them and come up with a plan that is fairly sensible 
and has worked well for 10 years' time. Well, now we have got a 
Democratic House and a Republican President. Is there any reason why 
this shouldn't work when the reverse worked 10 years ago? I am at a 
loss to explain that. I am at a loss to understand why it wouldn't work 
now.
  Mr. Speaker, I am a physician by trade. As a consequence, I 
frequently get to talk to doctors who come up to Congress to talk to us 
about the health policy decisions that we make and those that we should 
make and some of them we have made that have had unintended 
consequences. So I spend a lot of my time talking to physicians who 
come to Washington who are concerned about things. And a lot of doctors 
have been through town the past couple of weeks concerned about SCHIP 
and trying to learn more about it, trying to find out what all the 
fighting is about, why can't Congress agree on things.
  And I was talking to a group of probably 70 doctors at the end of 
last week, and I asked if anyone in the audience practiced pediatrics. 
And a gentleman raised his hand. And I said, Are you aware of the fight 
going on in Congress right now with the reauthorization of SCHIP? And 
he said, Yes, I've been following it some.
  And I asked him, When you are at home in your private practice of 
pediatrics and an SCHIP patient comes in, for the reimbursement for the 
services you render for that patient, does the government treat you the 
same as a private insurance company does? Is your reimbursements rate 
identical for those two patients?
  He said, Oh, no. It's about a third less on SCHIP.
  So, sir, what would be the effect if we took your patients who are on 
private health insurance and moved more of them to SCHIP? Would that 
have a positive or negative financial impact on your practice?
  He said, It would be very negative, obviously.
  And I said, Would you have any difficulty? Would you be able to make 
up that difference?
  And he didn't have an answer for me. He was obviously doing some 
figuring in his head.
  But, Mr. Speaker, that points up one of the other problems here. When 
we expand the reach and grasp of the Federal Government in health care, 
what happens? When it comes time to shave a few dollars off the program 
to find dollars for something else or find dollars to expand the 
program, one of the first places we go, witness the Medicare program. 
What is the number one complaint we hear from providers all over the 
country about the Medicare program? It is not that their patients can 
now get prescription drugs. It is that every year they face a 5 to 10 
percent reduction in reimbursement rates for providers because of the 
way the Medicare program is scheduled and structured.
  Can we honestly take a step back and say it would be a good thing to 
do that to the pediatricians of this country? We are having enough 
trouble right now with the health care workforce. Do we think we are 
going to improve that if we expand the size and grasp of the Federal 
Government and, as a consequence, ratchet down reimbursement rates for 
pediatricians? Do we expect to find more pediatricians in our community 
or less? I think you know the answer to that.
  Now, Mr. Speaker, there is one other aspect to this, and I am always 
advised by people who advise me about communications and, in talking 
with regular people, that no one wants to hear about process in 
Washington. But, after all, we are about process here in this House, 
and I think it is worthwhile to at least mention once again some of the 
process problems that have given us this impasse on the State 
Children's Health Insurance Program. Remember, in this body I could 
probably name one or two people that wouldn't have voted for a sense of 
the Congress that said we want to reauthorize SCHIP this year. If we 
all gathered here in January and said before the fiscal year is over, 
do you want to reauthorize SCHIP or not, I don't know if there would 
have been a single negative vote had that been taken on the floor of 
the House in January.
  So how do we get here where we are? I would submit to you it has been 
the activities of House leadership, the way this bill was brought to 
the floor. No

[[Page H11635]]

legislative hearings, no subcommittee markup. A full committee markup 
that was a joke and then pushed to the House floor, and, oh, by the 
way, if you have got amendments, don't bother to stay up late for the 
Rules Committee because we are not going to entertain them.

                              {time}  2200

  And that bill was so fatally flawed it died a tortured death during 
the month of August and then resurrected. The Senate had a bill. The 
House bill was so flawed, there was no way they could go to conference 
between the two of them, so we did kind of a conference but kind of not 
a conference, where we just kind of sprung from the Earth out of whole 
cloth a new House bill that was remarkably similar to the Senate bill, 
but it wasn't a conference report. It was brought to the floor of the 
House like a conference report, that is, once again, no hearings, no 
subcommittee markup, no full committee markup, no possibility of 
amending or improving the bill, even though it's a brand new bill. It 
had never been through the committee process. It was the Senate bill 
that just kind of got massaged a little bit, given a House number, and 
here we go, it's a conference report. But it's not, and no one believed 
that it was. But we treated it like one, we brought it to the floor of 
the House, it was voted up or down, no possibility for amendment. The 
vote passed, but not with enough numbers to override the Presidential 
veto. And that's what we will face at the end of this week.
  The Democratic leadership asked for an additional 2 weeks to make 
their case to the American people. Well, they've had their 2 weeks; 
they've made their case to the American people. And as people look at 
this bill, they say, I don't know if we want to encourage people to 
drop their private coverage to go on a Federal program, and that's 
because the American people are a lot smarter than a lot of us about 
these things.
  Mr. Speaker, I would give to you as an example of how things can be 
done correctly, we reauthorized the Food and Drug Administration 
earlier this year. That also came through my committee. We had 
hearings, we had a subcommittee markup, we had a full committee markup. 
The original legislation that I saw early in June was so awful I didn't 
even want to be associated with it as it came through the process. But 
we worked on it. We worked on it in the subcommittee, we worked on it 
in the full committee, we amended it. Staff had meetings between times. 
We coaxed it along. And at the end of the day, we had a bill that I 
think 400 of us could support when it came to the floor of the House. 
And then it went over to the Senate, similar activity. And then a 
conference report came back to the House, it went to the President and 
was signed. The biggest change and restructuring of the Food and Drug 
Administration in 40 years.
  We heard the other side talking about it just a little while ago. We 
need to give the FDA the tools it needs to be able to function in the 
21st century world. And guess what? In my committee we did that, and we 
did it the right way. We did it by working through the process. Yes, 
the Democrats were still in charge. Yes, they could have defeated every 
one of my amendments on a party line vote. But you know what? They 
didn't. Or if it was defeated, the chairman said, Well, we're going to 
look at that in the conference process, I promise you. And as a 
consequence, we got a bill that should be the model for the way 
legislation passes through this House of Representatives. And instead, 
when just a few months later it came time to reauthorize the State 
Children's Health Insurance Program, we got a tragedy of a bill.
  Now, even just today we marked up a bill in full committee, after a 
subcommittee markup last week, on mental health parity. I didn't agree 
with a lot of things in the bill, but I had a chance to have my say. I 
got the chance to put my ideas out there and have them voted on by the 
committee. I knew I wasn't going to win on the votes, but I knew I had 
to present my argument. People watched that on C-SPAN. People will see 
that in the committee record. Over time, if I'm right, then I will win 
the argument of ideas. But if we never have the opportunity to debate 
it in committee, how is anyone going to know? How is anyone going to 
know? Sure we're going to lose the vote because we don't have the 
numbers over here, but if we never get a chance to debate the ideas, 
how are the American people going to decide when they look at this 
critically and say, I don't think that's a good idea. Well, we should 
give the American people that chance; the fact that we're not is just 
flat wrong.
  We'll have our chance to vote on the bill this Thursday. I'm not a 
prognosticator. I don't know how it will turn out. I think it is the 
correct thing to do to support the President's veto and bring this bill 
back to the House. And I hope people of goodwill can get together and 
work on it, but, Mr. Speaker, I've got to tell you, although I'm 
generally optimistic about things, I'm worried. I'm worried that we've 
decided we have a political bludgeon that is just too important to use 
to hold on to power. And that's a tough thing for me to say, but all of 
the articles I read in the throw-away journals out here lead me to 
believe that.
  Now, Mr. Speaker, think back on 1996, when welfare reform was passed 
by this House. Again, you had a Republican House of Representatives, a 
Republican Senate. It passed welfare reform, then President Clinton 
vetoed it. It goes too far. You're going to put people out on the 
streets. It's a bad bill. So they came back, they passed it again. They 
didn't include any Democrats in the process, they just passed it again. 
And President Clinton looked at it and said, It's a bad bill. I'm going 
to veto it. So the third time both sides did get together and changed 
some things, albeit fairly modestly, but ended up with a bill that had, 
at the end of the day, both Republican and Democratic input, and the 
President was able to sign the bill.
  I hope we have a repeat of that story in 2007 with the State 
Children's Health Insurance Program because the program is that 
important it requires involvement from both sides. It's a travesty to 
eliminate any single Member from the process because each one of us is 
charged with representing about 650,000 people back in our home 
districts. Is it right to simply silence those 650,000 voices, say no, 
you don't get a say in this because we're the majority party, we're in 
charge and what we say goes? The American people don't want to see 
that. I think they will have ample opportunity to judge both sides by 
their actions and by their words this Thursday, and most importantly, 
follow what occurs after that. Because if, indeed, the two sides can 
sit down together and work out realistically what may be some very 
modest differences between the bills, if that can happen, Mr. Speaker, 
we score a win for the American people. If that can't happen, if the 
allure of the perfect political bludgeon is too great and that bludgeon 
is seized and raised above the head and walked out of this Chamber with 
it to simply bash the opposition political party for another 12 years 
before the next legislation, well, I think the American people will be 
the big losers there.
  Mr. Speaker, this is an important bill, it's an important subject. 
The reauthorization of the State Children's Health Insurance Program is 
supported almost unanimously in this body. So how did we get to a point 
where we have a bill that everyone wants to see reauthorized and no one 
wants to sit down and work on it? That's not a good work product for us 
to turn in for the American people.
  Now, Mr. Speaker, after the bill passed, the Democrats passed the 
bill at the end of September, most people don't know what happened in 
this Chamber 2 days later. Remember, the bill was going to expire the 
30th of September. Did it? Did it go away? Is there a State Children's 
Health Insurance Program right now? Yes, there is. We passed a 
reauthorization very quietly with a continuing resolution 2 days later, 
September 29th, here on the floor of this House, and that legislation 
is law and lasts until November 16th, when our target adjournment date 
is. I hope we get our work done by November 16th or 17th. I'm not 
overly optimistic that we will, but I hope we do. I know if I were a 
Governor of a State and looking at what dependability do I have for 
these funds coming in to help me take care of the poor children in my 
State, I wouldn't want to see that meted out in small little two- or 
three-

[[Page H11636]]

month segments. That's too hard. That's too hard to make decisions. 
That's too hard to govern with that kind of apportionment.

  So, if we are not able to come to a decision before the 16th of 
November, I would argue for a much longer term of reauthorization under 
a continuing resolution. And although the numbers would stay the same, 
as they were in the bill that was passed in 1997, the dependability of 
having those founds I think is something most State Governors would 
want. I hope that State Governors will weigh in on this issue with 
Members of both political parties and impress upon them the importance 
of providing the stability of that source of funding as we go forward 
in this process.
  Mr. Speaker, again, remember, the population of children that was 
originally the object of focus in the original State Children's Health 
Insurance bill were those children, that population of children that 
was between 150 percent and 200 percent of the Federal poverty limit. 
Ask yourself the question, where we are today, have we covered the 
majority, 90 or 95 percent of the children in that bracket? And the 
answer to that question is no. Let's do the hard work of finding those 
children, identifying them, and getting them into the program. Let's do 
that hard work before we go after easier applicants in higher income 
brackets.
  The whole intent of the program was to provide the coverage for those 
who needed it the most; and Mr. Speaker, they still need it. Their 
needs have not changed. Even though our focus has changed to 
successively higher income groups, those children in the 150 to 200 
percent of poverty, too much money to be covered under Medicaid, not 
enough money to buy private health insurance for about half of them, 
there are children in that bracket who remain uncovered to this day.
  Let's put our outreach efforts on those children. Let's put our focus 
on those children and bring those children into a condition of coverage 
before we begin to vastly expand the program. And I think that's the 
message that has been delivered by the ranking member of my Committee 
on Energy and Commerce, Ranking Member Barton, the ranking member of my 
subcommittee, Ranking Member Deal. That's been the message. That's been 
the focus that they have consistently articulated on the floor of this 
House, and they're exactly correct. If we don't want to do the hard 
work, the American people will see through that. And if we just simply 
want to bring other children into the program, children who already 
have coverage from some other location, to expand the program, just 
simply expand the program for expansion's sake, to expand the reach and 
grasp of the Federal Government, are we doing right by those children 
that are just too tough for us to find? No, I don't think so.
  I think, although it's hard work, it's good work. I think the States 
have the means, the mechanism and the capability of finding those 
children. And that's what we ought to be about in this body, 
encouraging them to find those children and bring them into the 
program. Then, and only then, can we talk about expansion beyond that 
limit. And if, indeed, we can show that across the country we have 
identified those children, we have brought them into the program, and 
then we want to talk about expansion and there's the money there to do 
it, I'm all for it. But until we identify those children, until we have 
made certain that we have covered the children that we were supposed to 
cover in the first place, we really don't have any business trying to 
expand the program.
  I would argue for an upper limit being placed at 250 percent of 
poverty. I think that is a reasonable upper limit. If we cover 95 
percent of the children below 200 percent of poverty and then we expand 
that to children up to 250 percent of poverty and we do a good job of 
identifying those children, I think the SCHIP program is functioning as 
intended and providing the coverage it needs to provide.
  And Mr. Speaker, let me just go back to the previous slide for a 
moment. If we identify those children, and perhaps expand to cover some 
children who are in up to the 250 percent of poverty, fill in the gaps, 
look what's happened. We're covering almost all the children in the 
United States of America, and that's something of which every Member in 
this House can be proud, Republican and Democrat alike. And wouldn't it 
be great if we worked together to accomplish that instead of going 
after the cheap political hit and trying to advance our own power.
  Mr. Speaker, you have been very generous with your time tonight. In 
summation, I would just say once again, I favor the reauthorization of 
the State Children's Health Insurance Program. I want to see that 
program reauthorized. I want to see it done sensibly. I don't want to 
see us grow the reach and grasp of the Federal Government unreasonably. 
I want us to keep families involved in their own health care. And Mr. 
Speaker, I think we can do it. It is hard work. It is going to have to 
require some compromise on both sides, but after we sustain the 
President's veto on Thursday, I look forward to getting involved in the 
process and getting that work done because it's the right thing to do 
for America and it's the right thing to do for our kids.

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